By David Gannon
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Recent news of the death of a popular celebrity once again reminds us of the most common mental health problem today. It is estimated that 16 million Americans have experienced a bout of depression at some time in their lives. Sometimes it is hard to recognize that the feelings you are having is depression. It has so many faces. It often comes over you like a fog rolling in from the ocean. It can be gradual and you may not initially notice your symptoms. You may not know why you are feeling badly and can’t explain what is bothering you. People who know you will tell you that you don’t seem yourself. You have somehow changed.
Depression can be triggered by external events. A significant loss is a common one. Loss of a loved one or a relationship, loss of a job, loss of youth and loss of health are a possible triggers for depressive thinking. The initial reaction to any type of loss is called grief and looks very much like depression. Grief is time limited and is generally resolved within a reasonable period of time. If grief persists it can lead to “complicated grief” and major depression.
Depression does not have one single cause, such as an imbalance of levels of neurotransmitters in the brain. Most scientists now believe that depression is caused by a combination of biology (neurochemicals), genetics, health, personality, and external stressors. It is more helpful to think of risk factors than actual causes. Dopamine, serotonin, and norepinephrine are neurotransmitters that seem to play a role in depression but there is no diagnostic lab test for this. Brain imaging techniques also show that the brains do not “light up” as much when someone is depressed, suggesting reduced activity level in some areas.
Another risk factor for depression is your genetic history. You are more susceptible to depression if it runs in your family. If you have chronic pain, heart disease, thyroid problems, diabetes or cancer, you are more likely to experience feelings of depression. Some medications prescribed for your medical conditions can also cause depression. Abuse of alcohol and other substances can cause depression and also make it worse. People who have personalities that are negative and pessimistic; have low self-esteem; and are alienated from others will be more likely to experience depression. If you live alone and are socially isolated you are a greater risk. In some cases it may be difficult to determine when depression is the cause of some problems and when it is the result of these problems.
Depression comes in many forms and there are degrees of depression. Major depression is not the sadness or the blues that most people can temporarily feel at times. It is more distressing and interferes with one or more major areas of life. Dysthymia is a form of mild depression that is less intense but can last for years if untreated. Depression can also be a part of bipolar disorder. Major depression looks a little different for each person. When you suffer from major depression it seems that you will never feel happy again. You lose all sense of perspective about life. Perhaps you can’t even remember when you ever felt happy. It feels debilitating. You don’t feel that you can physically move due to feelings of heaviness in your body and fatigue. You may feel like sleeping most of the time. It could even cause real physical pain. Some people get more irritable and angry. Others experience pervasive sadness and hopelessness. You may lose interest in everything and have trouble concentrating and making decisions. Some people lose their appetite and others use food to cope. Some use alcohol or other drugs to numb themselves or try to feel better. People who are clinically depressed just want to run away from themselves to escape the feeling but the feeling seems to go wherever they are. Suicide is not common but possible with people who are depressed.
Major depression can be successfully treated and overcome with a combination of medications and psychotherapy. Medications are not just used to help you feel better but also address the imbalances in brain chemistry. Different antidepressants may need to be tried to find one that works best. People with major depression are not thinking clearly and have difficulty recognizing the distorted thought patterns that often contribute to these feelings. Psychotherapy can help you to recognize and correct these distorted and irrational thought patterns that cause and sustain depression. Having a positive and caring relationship with a therapist also seems to reduce the hopeless thinking and social isolation.
Everybody feels “down and out” at times, but it does not last. Major depression is a more severe and pervasive condition that needs professional attention. People can get better when they reach out for help from mental health services at a crisis center, mental health center, a private psychologist or psychiatrist in their community.
David Gannon, Ph.D., Psychological and Family Consultants, Canton, Ohio.
HealthStyle: Depression - a common mental health problem
By David Gannon